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Diabetic Nephropathy (DN) is a complication of Diabetes Mellitus and is associated with chronic and low-grade inflammatory burden. Novel inflammatory predictors, such as, C-reactive protein to serum albumin ratio (CAR) has been studied various inflammatory conditions, recently. Increased inflammatory burden accompany to both type 2 Diabetes Mellitus (T2DM) and DN, hence we aimed to compare CAR levels of the T2DM subjects with DN to those of without DN.Patients with T2DM were enrolled to the study. Study population grouped into two according to the presence (group A) or absence (group B) of DN. Characteristics and laboratory data, as well as CAR levels; of the study groups were compared.Median CAR levels of the groups A and B were 2.17% (0.02-13.2) and 0.39% (0.02-4.39), respectively (p0.001). CAR was found to be an independent risk factor for diabetic nephropathy (adjusted to age, BMI, fasting glucose, HbA1c, and body weight). One unit (0.1%) elevation in CAR increased the risk of nephropathy by 3.5 folds (p0.001, 95%CI: 2.24-5.45). CAR levels greater than 0.82% have 79% sensitivity and 78% specificity in predicting DN (AUC: 0.86 [95% CI: 0.80-0.92]; p0.001).In conclusion, elevated CAR levels are higher in type 2 diabetic patients with diabetic nephropathy. According to the ROC curve, a level higher than 0.82% presents the best sensitivity and specificity in the association with the presence of DN.

Background. Hashimoto’s thyroiditis (HT) is an auto-immune condition characterized with lymphocytic and fibroblastic infiltration of the thyroid gland. The rate of uric acid and HDL cholesterol – so called as uric acid to HDL ratio (UHR) has been shown to be elevated in inflammatory conditions diseases. We aimed to compare UHR and other laboratory parameters of the patients with HT to those values in healthy controls. Methods. The patients diagnosed with HT by medical history, physical examination, elevated thyroid autoantibodies in serum and characteristic sonographic findings in outpatient internal medicine clinics of our institution were enrolled to the present retrospective study. Age and sex matched healthy volunteers were enrolled as controls. UHR of the HT patients and control subjects were compared. Results. The mean UHR of the HT group was 11% ± 4 %, while UHR of the control group was 8% ± 2% (p Conclusion. We suggest that UHR is a reliable and useful marker for HT. Therefore, it may be helpful in establishing the diagnosis of HT in addition to other diagnostic tools.

Craniofacial reconstruction represents a major challenge due to the complex anatomical morphology. Although implant production has often been outsourced to external companies, in-house planning and manufacturing has developed in many centres. This note introduces a conceptualized modular mould system to perform any desired craniofacial reconstruction, named ‘Cubik’, inspired by the famous Rubik’s cube. A sophisticated virtual process is described that simulates realistic cranio-orbital resections, and the workflow to create multi-component moulds in order to achieve intraoperatively moulded implants is presented. The description focuses on the appropriate definition of interfaces between the subdivision surfaces of the planned implant, which is the key element to successful design and function of the moulds during surgery and is the peculiarity of the Cubik system. The use of Cubik does not prolong the overall duration of surgery, and it appears to be a very versatile tool, allowing personalized implants with different morphology to be created, which are suitable to cover every potential defect of the skull and the orbital region. This study extends the potential of in-house production, allowing highly accurate implantable craniofacial implants to be fabricated, and in the future this might represent a solution to achieve in-house replacement of other segments of the facial skeleton.

Background. Hypothyroidism requires treatment with levothyroxine (L-T4) to keep patients euthyroid. The rate of hospital admissions for chronic conditions decreased during COVID-19 era. We aimed to observe whether hospital admissions of the patients with hypothyroidism decreased during COVID-19 compared to the same time period in 2019. We also aimed to find out the rate of treatment compliance in subjects with hypothyroidism during pandemic era. Materials and methods. This cross-sectional study was performed on patients who applied to Internal Medicine Department of Abant Izzet Baysal University Hospital, and who received L-T4 replacement therapy due to hypothyroidism. 108 hypothyroidism patients were included in the study with their consent forms. The patients were divided into 2 groups according to the treatment compliance; either as compliant or incompliant patients. Results. The last TSH level of compliant group was significantly lower than incompliant group (p, Актуальність. Гіпотиреоз потребує замісної терапії левотироксином (L-T4), щоб підтримувати в пацієнтів стан еутиреозу. Кількість госпіталізацій з приводу хронічних захворювань зменшилась протягом ери COVID-19. Мета дослідження — встановити частоту госпіталізацій пацієнтів з гіпотиреозом під час пандемії COVID-19 порівняно з аналогічним періодом часу в 2019 році. Матеріали та методи. Дослідження було проведене серед пацієнтів, які звернулись у відділення внутрішньої медицини університетської лікарні Abant Izzet Baysal та отримували замісну терапію L-T4 внаслідок гіпотиреозу. 108 пацієнтів з гіпотиреозом були включені в дослідження, підписавши інформаційну згоду. Пацієнти були розділені на дві групи відповідно до прихильності до лікування: хворі, які відповідали вимогам лікування, і хворі, які не дотримувались режиму лікування. Результати. Рівень тирео­тропного гормона (ТТГ) перед включенням у дослідження у групі осіб, які відповідали вимогам лікування, був вірогідно нижчим, ніж у групі хворих, які не дотримувались режиму лікування (p

BACKGROUND Sodium intake is known to contribute to the development of hypertension, thus intake reduction is a cornerstone in the prevention and management of hypertension. The increase in renal sodium excretion might represent a further potential preventive and/or therapeutic opportunity. OBJECTIVE To explore the working hypothesis that an increased fluid intake can improve renal sodium handling towards a decrease in blood pressure. METHODS The SPA Project is a multicenter, observational, cross-sectional, cohort study investigating healthy children, aged 5-8 years as to sodium and fluid intake by means of urinary sodium and creatinine from multiple samples taken in different days in order to characterize them in lower/higher sodium and lower/higher fluid intake. Both SBP and DBP (by multiple office blood pressure measurements) were used as outcome measures. RESULTS Three hundred and thirty-nine healthy, nonoverweight children (51.6% boys) with a median age of 5.7 years old (IQR: 5.3-6.2) participated in the study but only 223 could be analyzed. Among children with higher sodium intake, those introducing more fluids, showed a significantly lower blood pressure (both systolic and diastolic) compared with those with lower fluid intake: systolic 86.0 ± 8.5 vs. 90.0 ± 8.1 mmHg; P = 0.014 and diastolic: 53.8 ± 4.9 vs. 58.6 ± 6.6 mmHg; P

Aim: The triglyceride / HDL cholesterol (TG/HDL-c) ratio is increased in a variety of diseases including, coronary heart disease and type 2 diabetes mellitus. However, its role in non-alcoholic hepatosteatosis is not well understood. In present study, we aimed to compare the TG/HDL-c levels of the patients with non-alcoholic hepatosteatosis to those of the healthy subjects. Methods: Medical data of the patients with non-alcoholic hepatosteatosis whom presented to the outpatient internal medicine clinics of our institution were retrospectively analyzed. Healthy subjects whom admissions to our clinics were due to check up were enrolled to the study as control group. TG/HDL-c of the groups compared. Results: TG/HDL-c level of the liver steatosis group (5 (2-22) %) was higher than the control group (2.7 (1-8) %), (p

A reduced nephron number may play a role in the pathogenesis of arterial hypertension (AH), and it is well recognized that individual nephron endowment is widely variable. However, nephrons count is technically impossible in vivo. Based on the observation that subjects with a reduced nephron mass exhibit an increase in renal functional biomarkers during acute dehydration, we hypothesized that cystatin C concentration during neonatal physiological dehydration could identify subjects with reduced nephron endowment. This is a prospective, observational, cohort study enrolling healthy, caucasian, term neonates born after an uneventful pregnancy. Two groups of newborns were compared: neonates born to fathers on antihypertensive treatment (HF) versus those born to proven normotensive fathers older than 40 years of age (NF). Enrolled newborns underwent cystatin C determination at the time of newborn screening. Forty newborns with HF and 80 with NF were enrolled. No differences in baseline characteristics were observed between the two groups except for the number of hypertensive grandparents higher among newborns to HF (47.8% vs. 21.1%; p: 0.001). Cystatin C was significantly higher in newborns with HF (1.62 ± 0.30 mg/L vs 1.41 ± 0.27 mg/L; p

Objective: Methotrexate is used to suppress inflammation in many rheumatologic conditions. Here we present an elderly patient who developed serious side effects due to methotrexate. A 78 year old male admitted to emergency department with oral mucosal bleeding, skin rash, decrease in oral nutrition intake and weakness. He had been using 5 milligrams of methotrexate as 2 tablets twice a day for 10 days, after he was diagnosed with psoriatic arthritis 15 days ago. A diagnosis of methotrexate intoxication established with history, physical examination and laboratory analysis, which revealed pancytopenia. His signs and symptoms, as well as pancytopenia were recovered on 6th day of the hospitalization. He had been treated with folinic acid and filgrastim along with supportive care. Although methotrexate treatment and toxicity is well established it is still a clinical challenge that all clinicians must be aware of. In conclusion, methotrexate intoxication is a clinical entity that can lead to serious clinical consequences, and it is essential to diagnose and initiate appropriate treatment without delay to prevent morbidity and mortality. Keywords: Methotrexate toxicity, Pancytopenia, Treatment, Folinic acid, Filgrastim, Inflammation, Psoriatic arthritis.

Objectives Cancer is a leading cause of disabling morbidities and death worldwide. Although there are various strategies for the management of cancer, the severe adverse effects negatively impact the patient’s quality of life. In addition, the development of resistance limits the efficacy of many chemotherapeutics. Many natural agents are capable of reducing the adverse effects associated with chemotherapy and improving the therapeutic outcome. Tangeretin, a polymethoxy flavone, is one of the promising natural anticancer agents. Key findings Tangeretin not only targets various malignancies but also synergizes chemotherapeutic agents and reverses cancer resistance. Hence, the application of tangeretin as an adjuvant in cancer chemotherapy would be a promising strategy. Summary This work critically highlighted the proposed anticancer activity of tangeretin and discussed its potential combination with various chemotherapeutic agents. Additionally, it shed light on tangeretin chemical derivatives with improved pharmacokinetic and pharmacodynamic activity. Finally, this review described flavonoid biosynthetic pathways and how bioengineering can be employed to enhance the production yield of tangeretin. Thus, this work paves the way for the rational clinical utilization of tangeretin as a safe and effective adjuvant in chemotherapeutic protocols.

Bu çalışma evli kadınların aile içi şiddete maruz kalma durumunu ve etkileyenfaktörleri belirlemek amacı ile yapılmıştır. Tanımlayıcı ve kesitsel tipte olanaraştırmanın örneklemine, araştırmanın evrenini oluşturan 330 kursiyer kadından18 yaş ve üzeri, evli ve araştırmaya katılmayı kabul eden 220 kadın alınmıştır.Araştırma verileri “kişisel bilgi formu” “kadına yönelik aile içi şiddetibelirleme ölçeği” ile toplanmıştır.Verilerin değerlendirilmesinde sayı, yüzdelik dağılım ki-kare testi, ttesti ve varyans analizi kullanılmıştır. Araştırmaya katılan kadınların %69.5’igörücü usulü ile evlendiğini, %30.5’i eşinden şiddet gördüğünübelirtmiştir. Tanışarak evlenen,fiziksel hastalığı veya ruhsal hastalığı olan ve eşinden şiddet gördüğünü ifadeeden kadınların kadına yönelik ev içi şiddeti belirleme ölçeği puanortalamasının daha yüksek olduğu saptanmıştır. Bu sonuçlar doğrultusunda; kadınların aile içi eş şiddet türleri ve aileiçi eş şiddetinin tedavi edilmesi gereken bir sorun olduğu konusundabilgilendirilmesi, şiddet yaşantısındayardım ve destek alacakları kaynaklarının tanıtılması, şiddetin sonuçlarınayönelik farkındalıklarının artırılması önerilmektedir., This study was conducted with the aim to determine thestatus of married women exposed to domestic violence and related factors. Thepopulation of this descriptive study consisted of 330 trainee women who are 18years old and over and married, and the sample consisted of 220 women. Theresearch data were collected with “personal information form”, “domesticviolence against women scale”. Number, percentage distribution chi-square test,t test and variance analysis were used in the evaluation of the data. 69.5% ofthe women who participated in the study stated that they were married byarranged procedures and 30.5% stated that they were subjected to violence fromtheir spouses. Women who met and married, who had physical or mental illnessand who stated that they had been subjected to violence from their husbandswere found to have a higher mean score for determining domestic violenceagainst women.

Objective: Our aim was to investigate the relation between unilateral hippocampal and/or nigral alpha-synucleinopathy and cognitive dysfunction, anxiety and anhedonia. Materials and Methods: Female Sprague-Dawley rats were stereotactically injected adeno-associated viruses carrying alpha-synuclein (α-syn) into unilateral dentate gyrus (DG), substantia nigra (SN) or both SN + DG. The animals were tested for motor functions and memory, spatial learning, anxiety and hedony. Levels of α-syn and synaptophysin were evaluated by Western blot (WB) analysis. Results: In apomorphine-induced rotation test, a mild motor dysfunction was found in SN-α-syn group compared to control. DG- α-syn group showed memory impairment in novel object recognition test. All the α-syn injected groups spent more time to find the platform compared to controls in Morris water maze but this difference did not reach statistical significance. DG-α-syn group consumed more sucrose solution in sucrose consumption test and spent more time on the open arm in elevated plus maze, while the opposite was observed in SN-α-syn group compared to controls. We showed α-syn protein expression in the injected areas of all α-syn groups by WB and immunohistochemical staining. In WB analysis, both hippocampal and striatal synaptophysin expression levels were lower in the α-syn groups compared to controls. Conclusion: Parkinson’s disease (PD) is characterized by both motor and non-motor symptoms (NMS). However, an animal model recapitulating NMS with the background of dopaminergic denervation is still lacking. This model may help to investigate hippocampal α-syn pathology correlated especially with cognitive dysfunction and other NMS of PD.

Objective Persistent (≥2 months) major salivary gland enlargement in primary SS (pSS) patients is a well-known sign of possible involvement by B cell lymphoma. The study aimed to evaluate the diagnostic accuracy and safety of US-guided core needle biopsy (CNB) of major salivary glands compared with open surgical biopsy. Methods Prospective pSS patients (cases) with clinically persistent salivary gland enlargement underwent US-guided CNB and were compared with retrospective pSS patients (controls) submitted to open surgical biopsy. The features analysed were pre-biopsy clinical and laboratory findings, adequacy of the material for histology and diagnostic-rendered and biopsy-related complications (reported by the patient with a questionnaire and clinically verified). Results Thirteen cases underwent US-guided CNB: in nine, biopsy was performed on the parotid gland and in four it was performed on the submandibular gland. Sufficient material was obtained for pathological diagnosis in all samples. The final diagnoses were 5 (38.5%) B cell lymphoma, 1 (7.7%) lymphoepithelial sialadenitis, 4 (30.7%) other sialadenitis (granulomatous consistent with sarcoidosis, IgG4-related disease, chronic sclerosing, diffuse chronic) and 3/13 (23.1%) miscellaneous lesions. Thirteen controls underwent open surgical biopsy of the parotid. In one, inadequate material was obtained, while in 12 (92.3%) the pathologic diagnoses were 4 (33.3%) B cell lymphoma, 2 (16.7%) lymphoepithelial sialadenitis, 4 (33.3%) uncertain lymphoproliferative lesions and 2 (16.7%) miscellaneous lesions. Six cases (46.1%) reported six transient complications and 12/13 (92.3%) controls had 2 persistent and 14 transient complications. Conclusion US-guided CNB represents a novel, clinically relevant and safe approach for the management of pSS patients with parotid or submandibular persistent enlargement.

Objectives The aim of our study was to investigate the relationship between nutrition (adherence to Mediterranean Diet [MD] and Dietary Approaches to Stop Hypertension [DASH] diets) and cardiovascular disease risk factors in patients with traumatic lower limb amputation (LLA). Patients and methods A total of 35 male patients (mean age 36.9±9.3 years; range, 21 to 54 years) with unilateral traumatic LLA between April 2019 and November 2019 were included. Data including age, education status, clinical data, level of amputation, time of amputation, comorbidities, physical activities, medications including nutritional supplements were collected. Blood pressure and anthropometric measurements including weight, height, waist, hip, and upper median arm circumferences were measured. Three-day food records were evaluated to determine daily nutrient intake of each patient. The patients were divided into groups according to their diet scores. Results The DASH scores showed a moderate, negative correlation with the body mass index (BMI), hip circumference, waist circumference, waist-to-hip ratio, waist-to-height ratio, serum total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C). The MD scores showed a moderate, negative correlation with the BMI, waist circumference, hip circumference, waist-to-height ratio, serum TC, TG, and LDL-C. Conclusion Patients with traumatic LLA should be monitored closely for accompanying conditions such as cardiovascular diseases, and it is necessary to encourage them for healthy nutrition habits.

Background In March, 2020, the World Health Organization declared COVID-19 a pandemic. The absence of previous knowledge of COVID-19 has made decision-making difficult for all in health care, including surgical departments. We reviewed the management recommendations for surgical activity and changes to surgical practice, identifying concordances and discrepancies, based on the literature published in the early phase of the pandemic. Method We searched the electronic datasets, PubMed Database, Google, and Google Scholar, using the keywords “SARS-CoV-2”, “COVID-19”, “surgery”, “recommendations”, “guideline”, and “triage”. The search was limited to the first 2 months after the pandemic began and was closed on May 6, 2020. Results Twenty papers were included in the analysis and their recommendations are divided into the following categories: 1. general aspects, such as maintaining the safety of health personnel and indications for surgery. 2. The preoperative phase, with recommendations about activating different care pathways for COVID-19 positive patients. 3. The operative phase, with recommendations about activating safety measures for aerosol-generating procedures. 4. The postoperative phase, with recommendations for managing operating theatres and patient transfers. Conclusion The recommendations proposed in the revised documents are considered good practices aimed at keeping patients and healthcare professionals safe. However, these recommendations must be contextualized in each individual hospital.

Cardiopulmonary diseases are very common among the population. They are high-cost diseases and there are still no definitive treatments. The roles of members of the calcitonin-gene related-peptide (CGRP) family in treating cardiopulmonary diseases have been studied for many years and promising results obtained. Especially in recent years, two important members of the family, adrenomedullin and adrenomedullin2/intermedin, have been considered new treatment targets in cardiopulmonary diseases. In this review, the roles of CGRP family members in cardiopulmonary diseases are investigated based on the studies performed to date.

Background Empagliflozin, a sodium-glucose co-transporter-2 (SGLT-2) inhibitor, yielded significant beneficiaries in the treatment of type 2 diabetes mellitus (T2DM). It is particularly benefited the diabetic subjects with heart conditions. Aims We aimed to obtain a real-world data about the effects of empagliflozin add-on treatment on metabolic parameters, cardiovascular risk factors, and anthropometric measures in patients with T2DM. Methods Type 2 diabetic patients with established coronary heart disease whom empagliflozin added to their treatment were enrolled in the study. Anthropometric measures, clinical and laboratory data, were obtained before and at the 6th month of the empagliflozin treatment. All data before and at the 6th month were compared. Results Body weight (p

Simple Summary The most frequent intracranial neoplasm is meningioma. About 30% of these are represented by skull base meningiomas (SBMs). Patients with SBMs can be treated with a multimodal approach based on surgery, medical treatment and radiation-based therapy; however, the gold standard treatment for the majority of symptomatic meningiomas is still surgery. Surgical intervention is performed with the goal of maximum safe resection. This, however, poses technical challenges because of the proximity of these tumors with deep critical neurovascular structures, tumoral texture and consistency. A multimodal treatment, in combination with stereotactic radiosurgery and radiation therapy, is thus of utmost importance to achieve a satisfactory functional outcome and tumor control. The aim of this review was based on the identification of optimal multidisciplinary management of patients with SBMs. The investigation includes the relevant biological and clinical characteristics, the novel therapeutic approaches, highlighting the importance of a specialized multidisciplinary team, which is mandatory for SBM management. Abstract The surgical management of Skull Base Meningiomas (SBMs) has radically changed over the last two decades. Extensive surgery for patients with SBMs represents the mainstream treatment; however, it is often challenging due to narrow surgical corridors and proximity to critical neurovascular structures. Novel surgical technologies, including three-dimensional (3D) preoperative imaging, neuromonitoring, and surgical instruments, have gradually facilitated the surgical resectability of SBMs, reducing postoperative morbidity. Total removal is not always feasible considering a risky tumor location and invasion of surrounding structures and brain parenchyma. In recent years, the use of primary or adjuvant stereotactic radiosurgery (SRS) has progressively increased due to its safety and efficacy in the control of grade I and II meningiomas, especially for small to moderate size lesions. Patients with WHO grade SBMs receiving subtotal surgery can be monitored over time with surveillance imaging. Postoperative management remains highly controversial for grade II meningiomas, and depends on the presence of residual disease, with optional upfront adjuvant radiation therapy or close surveillance imaging in cases with total resection. Adjuvant radiation is strongly recommended in patients with grade III tumors. Although the currently available chemotherapy or targeted therapies available have a low efficacy, the molecular profiling of SBMs has shown genetic alterations that could be potentially targeted with novel tailored treatments. This multidisciplinary review provides an update on the advances in surgical technology, postoperative management and molecular profile of SBMs.

Coronaviruses, a large family of single-stranded RNA viruses, can infect humans and animals, and can cause neurological, gastrointestinal and hepatic diseases as well as causing various lung diseases, including pneumonia, with shortness of breath, cough and fever. At the end of December 2019, a group of health authorities reported unidentified cases of pneumonia in a seafood market in Wuhan, China. The World Health Organization (WHO) used term 2019 novel coronavirus (COVID-19) to refer to a coronavirus that affected the lower respiratory tract of patients with pneumonia in Wuhan, China on 29 December and the WHO announced that the official name of the 2019 novel coronavirus was coronavirus disease (COVID-19). COVID-19 is seen in many countries around the World and has been accepted as a pandemic by WHO. It is defined as a suspicious case with fever, sore throat, cough, and people with a history of traveling to China or some parts of the country, or someone who contact with a patient who has a history of travel in China or contact with a confirmed COVID-19 infection patient. Currently, there is no proven vaccine or antiviral therapy that can be used against animal or human coronavirus. To control the outbreak, the drugs must be developed as soon as possible. Various drugs have been used in the treatment of COVID-19 and the main ones are chloroquine, remdesivir, lopinavir/ritonavir, oseltamivir, favipiravir. Since the virus affects the whole World, vaccines and/or new curative antiviral drugs are needed to end the pandemic. For this purpose, large-scale observational studies are needed.

SUMMARY OBJECTIVE: Non-alcoholic fatty liver disease, which is characterized by lipid being deposited into hepatocytes, affects nearly one in three adults globally. Inflammatory markers were suggested to be related with hepatic steatosis. Uric acid to HDL cholesterol ratio is proposed as a novel inflammatory and metabolic marker. We aimed to compare Uric acid to HDL cholesterol ratio levels of patients with Non-alcoholic fatty liver disease to those of healthy controls and find out potential correlations between Uric acid to HDL cholesterol ratio and other inflammatory and metabolic markers of Non-alcoholic fatty liver disease. METHODS: Patients with a diagnosis of Non-alcoholic fatty liver disease who were on clinical follow-up in our institution were enrolled in the study as the Non-alcoholic fatty liver disease group, while healthy volunteers were enrolled as the control group. The Uric acid to HDL cholesterol ratio of the groups was compared and potential correlations were studied between Uric acid to HDL cholesterol ratio and fasting blood glucose, transaminases, serum lipids (triglyceride, LDL-cholesterol), weight, and body mass index. RESULTS: The Uric acid to HDL cholesterol ratio of the Non-alcoholic fatty liver disease (13±5%) group was significantly higher compared to the Uric acid to HDL cholesterol ratio of the control (10±4%) group (p

É crescente a presença de plataformas e serviços de empresas privadas de software no ensino público. Isso traz à tona preocupações que incluem a autonomia tecnológica de redes e instituições, o tratamento de dados estratégicos e sensíveis e a privacidade de alunos, professores, gestores e responsáveis. No entanto, ainda pouco sabemos sobre a extensão dessas parcerias e o teor desses acordos. Este trabalho apresenta uma análise das parcerias estabelecidas entre instituições públicas de ensino superior e redes de ensino com duas empresas associadas ao chamado ‘capitalismo de vigilância’. O trabalho partiu de solicitações realizadas via Lei de Acesso à Informação às secretarias de educação de estados e instituições públicas de ensino superior no Brasil. Os resultados indicam adesão massiva a esses serviços e pouca clareza quanto ao teor das parcerias. Por fim, os dados permitiram a validação e aprimoramento de um script que faz a coleta automática de dados e permite uma visualização atualizada do capitalismo de vigilância na educação brasileira. Public education has seen a surge in the presence of platforms from large private software companies. This in turn has raised concerns in regards to technological autonomy of school systems and institutions, the treatment of strategic and sensitive data, and the privacy of students, teachers,administrators, and legal guardians. However, we know little about the extent of these partnerships and the substance of these agreements. This article presents data on partnerships established between higher education institutions and state educational systems with two companies associated with 'surveillance capitalism': Google and Microsoft. The work is based on requests made via the Access to Information Law (LAI). The results indicate massive adherence to cloud services offered by these businesses and little clarity in regards to the content of the partnerships. Finally, the data allowed for the validation and improvement of a script that automatically collects data and allows for an up-to-date visualization of surveillance capitalism in Brazilian education. La presencia de plataformas y servicios de empresas privadas de software en la educación pública es cada vez mayor. Esto plantea preocupaciones que incluyen la autonomía tecnológica de las redes de enseñanza e instituciones, el tratamiento de datos estratégicos y sensibles, y la privacidad de los estudiantes, profesores, administradores y tutores. Todavía sabemos poco sobre el alcance de estas asociaciones y el contenido de estos acuerdos. Este trabajo presenta datos sobre la adhesión de las instituciones públicas de educación superior brasileñas y los departamentos de educación estatales a los servicios educativos de dos empresas asociadas al llamado "Capitalismo de Vigilancia", Google y Microsoft. El trabajo hizo uso de informaciones obtenidas a través de solicitudes mediante la Ley de Acceso a la Información de Brasil (LAI). Los resultados indican una adhesión masiva a los servicios "en la nube" de las empresas y poca información acerca de los modos de adhesión a los servicios. Por último, los datos permitieron validar y mejorar un script que recoge automáticamente los datos y permite tener una visión mas completa y actualizada del capitalismo de vigilancia en la educación brasileña.

The emergence of the COVID-19 pandemic has mandated the instant (re)search for potential drug candidates. In response to the unprecedented situation, it was recognized early that repurposing of available drugs in the market could timely save lives, by skipping the lengthy phases of preclinical and initial safety studies. BenevolentAI’s large knowledge graph repository of structured medical information suggested baricitinib, a Janus-associated kinase inhibitor, as a potential repurposed medicine with a dual mechanism; hindering SARS-CoV2 entry and combatting the cytokine storm; the leading cause of mortality in COVID-19. However, the recently-published Adaptive COVID-19 Treatment Trial-2 (ACTT-2) positioned baricitinib only in combination with remdesivir for treatment of a specific category of COVID-19 patients, whereas the drug is not recommended to be used alone except in clinical trials. The increased pace of data output in all life sciences fields has changed our understanding of data processing and manipulation. For the purpose of drug design, development, or repurposing, the integration of different disciplines of life sciences is highly recommended to achieve the ultimate benefit of using new technologies to mine BIG data, however, the final say remains to be concluded after the drug is used in clinical practice. This review demonstrates different bioinformatics, chemical, pharmacological, and clinical aspects of baricitinib to highlight the repurposing journey of the drug and evaluates its placement in the current guidelines for COVID-19 treatment.

Parkinson’s disease (PD) is a progressive disease due to dopaminergic cell loss in the substantia nigra and dopaminergic terminal lost in the striatum, which is the projection area of substantia nigra. It is characterized by resting tremor, bradykinesia, rigidity, and postural instability. In PD, non-motor symptoms such as cognitive impairment, anhedonia, apathy, and autonomic nervous system impairments affect quality of life as much as motor symptoms. PD may affect multiple systems and the underlying mechanisms are not known. However, developing new methods of treatment to slow or stop the rate of disease progression, to lessen or to cure the symptoms is crucial. The aim of this review was to discuss the alternative treatments that may be useful for both motor and non-motor symptoms. Symptomatic treatments with dopaminergic drugs aim to relieve motor symptoms and to increase the patient’s life standards for a limited time. However, possible neuroprotective treatments that inhibit neuronal cell death can extend life span and provide higher quality of life. Lewy bodies, which are formed mainly from misfolded and native alpha-synuclein protein, is a pathologic hallmark of PD. Therefore, inhibiting the protein misfolding or clearing the aggregates could be a promising new therapeutic approach for the disease.

Objective To determine the beliefs and attitudes towards diabetes of rural health care providers in Aklan, Philippines using the Diabetes Attitude Scale 3 (DAS-3) and to determine factors associated with it. Methodology This is a cross-sectional analytic survey. A total of 339 health care providers were given self-administered DAS-3 questionnaires. Additional data gathered included their age, highest educational attainment, position, municipality class, diabetes as a co-morbidity, attendance to diabetes classes, and family history of diabetes. Results Rural health care providers showed an overall mean positive attitude score of 3.5 using the DAS-3 questionnaire. In decreasing order, mean scores of participants according to subscale is as follows: “Need for Special Training in Education” (4.13) >“Autonomy of diabetes for patients” (3.70) >“Psychosocial Impact of Diabetes” (3.60) >“Value of Tight Glucose Control” (3.14) and “Seriousness of Type 2 Diabetes” (3.09). Physicians have the highest mean scores consistently in all subscales compared to other health care providers. Among the different factors considered, educational attainment (p=0.005) and work position (p=

Background Maxillary fungus ball (FB) is the most frequent paranasal localization. Objective To review clinical presentation, surgery and results of treatment in our series of patients with maxillary FB. To review the literature concerning treatment of maxillary FB. Patients and methods 48 patients with a diagnosis of maxillary FB were treated with endoscopic sinus surgery (ESS) alone or in association with external approaches. Before surgery all patients received computed tomography (CT), nasal endoscopy and dental examination. All the patients were followed for 1 year after surgery. Studies concerning surgical treatment of maxillary FB from 2006 were reviewed. Results The mean age of patients was 53.6 ± 11.9 years. 20 patients (41.6%) did not present any symptom, 19 patients (39.7%) had nasal symptoms, 3 patients (6.2%) had facial pain, 6 patients (12.5%) had a combination of both. Endoscopic examination was positive in 31 patients (64.6%), 17 patients (35.4%) showed negative findings. Logit regression model demonstrated that clinical symptoms contribute to the prediction of a positive endoscopic examination. 25 patients (52.1%) presented odontogenic factors. Complete clinical and radiological resolution of FB was observed in 46 patients (95.8%). Conclusions Comparing our sample to the studies reviewed we may concluded that odontogenic factors were frequently reported and should be treated at the same time of maxillary FB. ESS alone or in association with external approaches is an effective treatment for patients with maxillary FB.

Complex craniofacial surgery has been later to take advantage of computerized planning than traditional maxillofacial procedures. Virtual reality, 3D model navigation, and bioengineering analyses have changed our approach to the surgical planning of craniofacial resection, increasing the benefits of surgery in terms of accuracy while decreasing complication rate. This study introduces a new workflow for 3D reconstruction, virtual model navigation, and alignment analyses, and demonstrates its successful application in a sample of four patients. A case of squamous cell carcinoma of the maxillary and ethmoid sinus in a 62-year-old patient is presented to evaluate the application of the workflow for a combined transfacial and transcranial resection. Results demonstrate that virtual surgical planning was successfully translated into navigational coordinates and reproduced in the operating room. While the literature provides a wide range of applications of virtual planning for traditional maxillofacial procedures, its introduction for complex craniofacial procedures remains difficult. The presented case shows that it is worth investigating the correlation between virtual reality planning and surgical accuracy for craniofacial resection, and related advantages in terms of surgical safety and improved prognosis.

The purpose of this study was to evaluate the accuracy of temporomandibular joint (TMJ) custom-made replacements by means of virtual surgical planning. The authors review 11 TMJ custom-made prostheses made of both mandibular and fossa components. Surgeries were virtually planned and patient-specific devices were designed together with surgical cutting and positional guides. Three-dimensional models for both preoperative planning and postoperative computed tomography scans were generated and overlapped in order to evaluate differences in measurements. Correlation between virtual preoperative and real postoperative prosthesis positioning was described by Lin’s coefficient. Results of statistical analysis showed an almost perfect concordance. Wilcoxon’s matched-pairs test showed no statistically significant deviation between preoperative virtual surgical planning and postoperative results. Colour map analysis confirmed the correspondence between virtually planned positioning of the devices and postoperative results. All the prostheses were placed with great accuracy. In conclusion, virtual surgical planning, surgical guides and patient-specific devices provide accuracy and precision in surgery for custom-made TMJ replacement.

Alzheimer's disease (AD) is an irreversible, progressive neurodegenerative brain disorder with no current cure. One of the important therapeutic approaches of AD is the inhibition of β-site APP cleaving enzyme-1 (BACE1), which is involved in the rate-limiting step of the cleavage process of the amyloid precursor protein (APP) leading to the generation of the neurotoxic amyloid β (Aβ) protein after the γ-secretase completes its function. The produced insoluble Aβ aggregates lead to plaques deposition and neurodegeneration. BACE1 is, therefore, one of the attractive targets for the treatment of AD. This approach led to the development of potent BACE1 inhibitors, many of which were advanced to late stages in clinical trials. Nonetheless, the high failure rate of lead drug candidates targeting BACE1 brought to the forefront the need for finding new targets to uncover the mystery behind AD. In this review, we aim to discuss the most promising classes of BACE1 inhibitors with a description and analysis of their pharmacodynamic and pharmacokinetic parameters, with more focus on the lead drug candidates that reached late stages of clinical trials, such as MK8931, AZD-3293, JNJ-54861911, E2609, and CNP520. In addition, the manuscript discusses the safety concerns and insignificant physiological effects, which were highlighted for the most successful BACE1 inhibitors. Furthermore, the review demonstrates with increasing evidence that despite tremendous efforts and promising results conceived with BACE1 inhibitors, the latest studies suggest that their clinical use for treating Alzheimer's disease should be reconsidered. Finally, the review sheds light on alternative therapeutic options for targeting AD.

OBJECTIVES Type A aortic dissection (TAD), which consists of an intimal tear in the aorta, necessitates emergency surgery. Various risk factors related to aortic dissection have been defined in the literature. According to our hypothesis, a narrower angle of ascending aortic curvature (AAAC) may be an additional risk factor in relation to aortic dissection due to the increased force applied to the aortic wall. METHODS Patients undergoing ascending aortic surgery due to an ascending aortic aneurysm (AsAA) (n = 105) and patients undergoing such surgery because of the occurrence of TAD (n = 101) were enrolled in this study. The AAAC was measured using Cobb’s method; the measurements were made on all patients by just 1 cardiovascular radiologist using 3-dimensional computerized tomographic imaging. This measurement was made indirectly by using the aortic valve and brachiocephalic artery to avoid obtaining misleading data as a result of distortions due to dissection. A statistical comparison was also performed relating the traditional risk factors for TAD to other clinical and echocardiographic parameters: the diameter of the ascending aorta and the AAAC. RESULTS The AAAC was found to be narrower statistically in the TAD group (α = 76.2° ± 17.5°) than it was in the AsAA group (α = 92.9° ± 13°) (P CONCLUSIONS According to this study, the AAAC was significantly smaller in aortic dissection patients than in aortic aneurysm patients. This may be related to higher shear stress and elevated pressure on the ascending aorta in patients with a narrower AAAC. Thus, a narrower AAAC may be an additional risk factor in the development of TAD. Therefore, we may need to be more careful in terms of looking for the development of aortic dissection in patients with narrower AAAC.

In nuclear medicine, radiopharmaceuticals are used for diagnosis or treatment purposes. Radiopharmaceuticals containing radionuclide in their structure are produced by reactors, generators or cyclotrons and are generally used for scintigraphy or tomographic investigations. The produced radionuclides can be given to the human body together with organic or inorganic substances. In this study, the production reaction cross sections were calculated for two selected radiopharmaceutical nuclei (99Tc and 115In) using the semi-empirical cross section formula for the (n, α) reactions developed by Tel et al. (2008). The density depending on (n, α) reaction cross sections were also investigated with the four Skyrme Hartree Fock parameters (S3, T3, SKM and SKM*). While the calculated value from the semi-empirical formula developed by Tel et al. (2008) gave reasonable results, the density-dependent calculations were observed lower values than that of experimental values.

We are going to present a case of malignant fibrous histiocytoma in the right atrium, which is a very rare entity. The patient had a right atrial mass, which prolapsed through the tricuspid valve into the right ventricle, causing functional tricuspid valve stenosis. The tumor was completely resected and the patient had an uneventful postoperative period. Histopathological examination reported malignant fibrous histiocytoma. The patient presented to the emergency department five weeks after discharge with dyspnea and palpitation. Echocardiography and magnetic resonance imaging revealed recurrent right atrial tumor mass. His clinical status has worsened, with syncope and acute renal failure. On the repeated echocardiography, suspected tumor recurrence was observed in left atrium, which probably caused systemic embolization. Considering the aggressive nature of the tumor and systemic involvement, our Heart Council decided to provide palliative treatment by nonsurgical management. His status deteriorated for the next few days and the patient succumbed to a cardiac arrest on the 4th day.

Purpose This study was conducted to evaluate peer bullying, internet addiction, and psychological adaptation capabilities of students in the 9-15 age group. Design and methods The study was performed as cross-sectional-descriptive research with 880 students included in the research sample. Findings One-fourth of the students in the 9-15 age group suffered from psychological adaptation issues, one-fifth suffered from bullying issues, and 16.5% suffered from internet addiction. Conclusion There is a need for early determination in risky age groups, a collaboration between parents and teachers in schools, and extended social studies on the prevention of peer bullying and internet addiction.

Bu çalışmada, Francisella tularensis (F. tularensis)’e karşı gelişen antikorları saptamak için bir Enzyme- Linked Immunosorbent Assay (ELI SA) prototipi ve kristal viyole boyalı bir mikroaglütinasyon test (MAT) antijeni geliştirildi. Ayrıca konfirme edici Western blot (WB) tekniği de serumlara uygulandı. Alınan sonuçlara göre MAT, ELISA ve WB testlerinin tanısal duyarlılıkları %100 olarak bulunurken, özgüllükleri sırası ile %100, %98 ve %96 olarak bulundu. Geliştirilen MAT ve ELISA ile 72 insan serumunda seropozitiflik oranı her iki teste de %4.2 olarak bulunurken, 190 koyun serumunda MAT ve ELISA seropozitifliği sırası ile %3.2 ve %4.7 olarak bulundu. Alınan sonuçlara göre ülke mizde tularemi insan ve hayvanlarda varlığını sürdüren bir infeksiyondur. Ancak daha sağlıklı epidemiyolojik yorum yapabilmek için daha çok sayıda seruma ve farklı hayvan türleri ile çalışılmasına ihtiyaç bulunmaktadır. Sonuç olarak, ELISA ve konfirme edici Western blotting kombinasyonunun tulareminin serolojik tanısında kullanılabilecek uygun bir kombinasyon olduğu düşünülmektedir. In this study, a microagglutination test (MAT) antigen stained by crystal violet and an in house Enzyme- Linked Immunosorbent Assay (ELISA) prototip were developed in order to detect antibodies against Francisella tularensis. Besides, Western blot technnique was used as the confirmatory test. According to the results, diagnostic sensitivity of MAT, ELISA and WB was 100%, while diagnostic specificities of these tests were 100%, 98% and 96%, respectively. Seropositivity rates of serum samples taken from 72 human were 4.2% for both tests. Seroposi tivity rates of 190 serum samples from sheep were 3.2% for MAT and 4.7% for ELISA. Results seem that tularemia exists in both humans and in animals. However, in order to make more definitive evaluation about the disease, more serum samples taken from various animal species are needed to be tested for this disease. As conclusion, it was thought that ELISA and confirmatory Western blot will be suitable combination for serologic diagnosis of tularemia.

Aim: With the increase in the geriatric population, admissions to emergency units are increasing each day. This study aims todetermine the perspective and attitudes of emergency specialists towards geriatric patients, and to form a training program foremergency medicine to improve the quality of patient care.Materials and Methods: We conducted a complementary study designed as a survey. At the end of the study period, the data collectedwere recorded in SPSS for Windows 15.0 (SPSS Inc.®, Chicago, ABD) program package and statistically analyzed. The Chi-square,Yates corrected chi-square and the Fisher’s exact tests were used in order to define the relationship between the parameters. Thelevel of significance was accepted as p

BACKGROUND The present study aimed to investigate the eating behaviour, nutritional status and growth of Caucasian children in ages 2-6 years who had a diet because of cow's milk protein allergy (CMA) [immunoglobulin (Ig)E-mediated and/or non-IgE-mediated] in early childhood. METHODS In this cross-sectional, case-control study, the cow's milk elimination (CME) group comprised children aged 0-2 years who were receiving a CME diet because of CMA, as confirmed by an oral food challenge test, and had reintroduced cow's milk for at least ≥ 3 months. The control group never had a restricted diet. Eating behaviour and children's growth was assessed. A 3-day food record was taken to determine the macronutrient and micronutrient intake of the children. Data on the children's socio-demographic, infant nutrition and family allergy history were collected from their medical records and face-to-face interviews with mothers. RESULTS In total, 62 children with a median age of 32 months were recruited for the study. The total scores of food avoidance and satiety responsiveness in the CME group (n:31) were higher than in the controls (n = 31) (p = 0.036 and 0.006, respectively). Weight-for-age and height-for-age are statistically lower in the CME group than in the control group (p

Primary Sjögren’s syndrome (pSS) is a chronic and heterogeneous disorder characterized by a wide spectrum of glandular and extra-glandular features. The hallmark of pSS is considered to be the immune-mediated involvement of the exocrine glands and B-cell hyperactivation. This leads pSS patients to an increased risk of developing lymphoproliferative diseases, and persistent (>2 months) major salivary gland enlargement is a well-known clinical sign of possible involvement by B cell lymphoma. Better stratification of the patients may improve understanding of the mechanism underlying the risk of lymphoproliferative disorder. Here, we summarize the role of different imaging techniques and a bioptic approach in pSS patients, focusing mainly on the role of salivary gland ultrasonography (SGUS) and a US-guided core needle biopsy (Us-guided CNB) as diagnostic and prognostic tools in pSS patients with persistent parotid swelling.

The purpose of this study was to present an innovative approach for the preoperative assessment and intraoperative targeted excision of masses occupying the intraorbital space based on multimodal image fusion, segmentation, virtual models, digital planning, and navigation. Nineteen patients were studied and underwent surgery using the presented workflow, in both open and endoscopic procedures. Three main scenarios were standardized for the application of computer-guided surgery: single masses of the superior-lateral compartment, single masses of the inferior-medial compartment, and multifocal masses. An operative protocol was devised, and the accuracy of the osteotomies was analysed. All patients were managed successfully by applying the same protocol. No intraoperative complications were reported. The accuracy of the osteotomies was evaluated as a surrogate endpoint for the overall precision of surgery, showing average discrepancies of1 mm for lateral marginotomies and0.5 mm for endoscopic osteotomies. This study outlines an operative workflow for the implementation of virtual models to excise orbital masses, enhancing in-depth preoperative understanding of the anatomical relationships within the orbital space and increasing precision in both open and endoscopic approaches.

Introduction Atypical hemolytic uremic syndrome (aHUS) is mainly due to complement regulatory gene abnormalities with a dominant pattern but incomplete penetrance. Thus, healthy carriers can be identified in any family of aHUS patients, but it is unpredictable if they will eventually develop aHUS. Methods Patients are screened for 10 complement regulatory gene abnormalities and once a genetic alteration is identified, the search is extended to at-risk family members. The present cohort study includes 257 subjects from 71 families: 99 aHUS patients (71 index cases + 28 affected family members) and 158 healthy relatives with a documented complement gene abnormality. Results Fourteen families (19.7%) experienced multiple cases. Over a cumulative observation period of 7595 person-years, only 28 family members carrying gene mutations experienced aHUS (overall penetrance of 20%), leading to a disease rate of 3.69 events for 1000 person-years. The disease rate was 7.47 per 1000 person-years among siblings, 6.29 among offspring, 2.01 among parents, 1.84 among carriers of variants of uncertain significance, and 4.43 among carriers of causative variants. Conclusions The penetrance of aHUS seems a lot lower than previously reported. Moreover, the disease risk is higher in carriers of causative variants and is not equally distributed among generations: siblings and the offspring of patients have a much greater disease risk than parents. However, risk calculation may depend on variant classification that could change over time., Graphical abstract

Introduction Fractures of the zygomaticomaxillary complex (ZMC) represent an extremely heterogeneous group of injuries to the midfacial skeleton. Traditionally, the diagnosis of such fractures was based on 2-dimensional radiograms and, more recently, on volumetric computed tomography (CT) scans, while the treatment was exclusively based on the surgeon's experience. Many classification attempts have been made in the past, but no paper has taken into account the importance of virtual surgical planning (VSP) in proving a modernized classification. The authors propose a classification based on the use of VSP which can guide the surgeon to identify the optimal reduction method and reproduce it in the operating room through the use of navigation. Methods Patients with ZMC fractures were collected to create a study model. The VSP was used to generate 3-dimensional models of fractures. Fractured segments were duplicated and digitally put in the optimal reduction position. Repositioned fragments were overlapped to their original preoperative counterparts and exported to the surgical navigator to be navigated. Planned virtual reduction was overlaid to postoperative CT scan to assess the accuracy of reduction, explored using color maps and the calculation of root mean square error. Results For all patients, the application of VSP was successfully accomplished. High accuracy was confirmed between the planned virtual reduction and the postoperative CT scan. A 5-item classification based on VSP is proposed. All patients were included in the presented subclasses. Conclusions The adoption of virtual planning in ZMC fractures allows for an improved study of the displacement of the fracture and might indicate to the surgeons the required maneuvers to achieve optimal reduction. The presented proposal of classification might be an aid to simplify the choice of the most appropriate reduction method and might provide a deeper insight into the morphologic characteristics of fractures.

Patients with atypical hemolytic uremic syndrome (aHUS) have long been considered ineligible for kidney transplantation (KTx) in several centers due to the high risk of disease recurrence, graft loss and life-threatening complications. The availability of Eculizumab (ECU) has now overcome this problem. However, the best approach towards timing, maintenance schedule, the possibility of discontinuation and patient monitoring has not yet been clearly established. This is a single center case series presenting our experience with KTx in aHUS. This study included 26 patients (16 females) with a diagnosis of aHUS, who spent a median of 5.5 years on kidney replacement therapy before undergoing KTx. We compared the aHUS relapse rate in three groups of patients who underwent KTx: patients who received no prophylaxis, patients who underwent plasma exchange, those who received Eculizumab prophylaxis. Complement factor H-related disease was by far the most frequent etiology (n = 19 patients). Untreated patients and patients undergoing pre-KTx plasma exchange prophylaxis had a relapse rate of 0.81 (CI 0.30–1.76) and 3.1 (CI 0.64–9.16) events per 10 years cumulative observation, respectively, as opposed to 0 events among patients receiving Eculizumab prophylaxis. The time between Eculizumab doses was tailored based on classic complement pathway activity (target to

Treatment of cancer is a challenge. Chemotherapy agents used for its treatment damage healthy cells; the immune system is also disabled following treatment with the latest chemotherapy agents. Chemotherapy agents used also weaken the immune system, leaving the human body vulnerable, the patient may die, and serious difficulties faced in its treatment. We need safe chemotherapeutic agents which target cancer cells without damaging healthy cells. Ancient Egyptians believed that mushrooms were “agents of immortality”. Among Pharaohs, only the royal family could eat mushrooms. Mycochemistry of Ganoderma species has shown these could be used against cancer treatment. Cytotoxic activity-guided isolations have been done to find the potential drug. Phytochemical studies are done to find the immunomodulatory, antiviral, anti-inflammatory, α-glucosidase inhibitory, acetyl-cholinesterase and butyrylcholinesterase inhibitory, and antibacterial compounds. G. lucidum has been used as immunomodulator and antitumor agent. It is excellent source of bioactive mycochemicals. Other Ganoderma species are too studied for the potential to be used. The compounds (1–463) isolated from 17 Ganoderma species in the last two decades have been evaluated along with their anticancer and related biological activities. Meanwhile, terpenoids, steroids, phenolics, and alkaloids, indicating biological activity related to cancer from 17 Ganoderma species, are reported herein.

In the past years, endoscopic techniques have raised an increasing interest to perform minimally invasive accesses to the orbit, resulting in excellent clinical outcomes with inferior morbidities and complication rates. Among endoscopic approaches, the transantral endoscopic approach allows us to create a portal to the orbital floor, representing the most straightforward access to lesions located in the inferior orbital space. However, if endoscopic surgery provides enhanced magnified vision of the anatomy in a bloodless field, then it has several impairments compared with classic open surgery, owing to restricted operative spaces. Virtual surgical planning and anatomical computer-generated models have proved to be of great importance to plan endoscopic surgical approaches, and their role can be widened with the integration of surgical navigation, virtual endoscopy simulation, and augmented reality (AR). This study focuses on the strict conjugation between the technologies that allow the virtualization of surgery in an entirely digital environment, which can be transferred to the patient using intraoperative navigation or to a printed model using AR for pre-surgical analysis. Therefore, the interaction between different software packages and platforms offers a highly predictive preview of the surgical scenario, contributing to increasing orientation, awareness, and effectiveness of maneuvers performed under endoscopic guidance, which can be checked at any time using surgical navigation. In this paper, the authors explore the transantral approach for the excision of masses of the inferior orbital compartment through modern technology. The authors apply this technique for masses located in the inferior orbit and share their clinical results, describing why technological innovation, and, in particular, computer planning, virtual endoscopy, navigation, and AR can contribute to empowering minimally invasive orbital surgery, at the same time offering a valuable and indispensable tool for pre-surgical analysis and training.

Background: Sodium intake is known to contribute to the development of hypertension. The reduction of sodium intake is currently a cornerstone in the prevention and management of hypertension. Inducing an increase in renal sodium excretion might represent a further potential preventive and/or therapeutic opportunity .Methods: The SPA Project is a multicenter, observational, cohort study aimed at investigating blood pressure in relation to fluid and sodium intake with the working hypothesis that an increased fluid intake can improve renal sodium handling towards a decreased blood pressure. Children were investigated as to their sodium and fluid intake by means of urinary sodium and creatinine from 4 samples of urine taken in different days in order to characterize them in low/high sodium and low/high fluid intake groups. Both systolic and diastolic blood pressure (by multiple office blood pressure measurements) were used as outcome measures.Findings: Three hundred and thirty-nine healthy, non-overweight children (51.6% boys) with a median age of 5.7 years old (IQR: 5.3-6.2) participated in the study. Among children with higher sodium intake, those introducing more fluids, showed a significantly lower blood pressure (both systolic and diastolic) compared to those with lower fluid intake: systolic 86.0 + 8.5 vs 90.0 + 8.1 mmHg; p: 0.014 and diastolic: 53.8 + 4.9 vs 58.6 + 6.6 mmHg; p

User eXperience (UX) gains more and more importance due to technological complexity, task specialization, widening of users range, etc. All of this become particularly true in medical contexts, where affordance, empathy with devices, natural interaction, dialogue reliability, real time response, etc., can make the difference for completely successful surgical activities. The PIRG - Product Innovation Research Group and the Clinic of Maxillo-facial Surgery of the University of Udine worked together for investigating about the UX during maxillo-facial surgery planning and implementation. The goal was double-faced: analyze the UX in order to highlight possible needs for improvements and test the evaluation process in terms of tools and activities performed. The outcome consists of suggestions to improve the UX and of a review of the evaluation process.

There are several vaccines developed against COVID-19 infection. Inactivated viral vaccines are usually well tolerated. We aimed to present a relapsing immune thrombocytopenia case following inactive COVID-19 vaccine. Here we report a case of relapsing immune thrombocytopenia following inactivated viral vaccine against COVID-19 in a 60-year-old woman with a history of immune thrombocytopenia. The patient responded well to dexamethasone treatment and was discharged from the hospital with full recovery. We suggest that physicians seek the history of a recent inactivate COVID-19 vaccine shot in patients with immune thrombocytopenia.